Heart failure & cardiomyopathiesCohort study

Iron Deficiency in Heart Failure: Screening, Prevalence, Incidence and Outcome Data from the Swedish Heart Failure Registry and the Stockholm CREAtinine Measurements Collaborative Project

Eur J Heart FailPublished

  • Registry-based cohort study
  • Swedish heart failure (HF) registry
  • Region Stockholm

Authors' conclusion

Iron deficiency screening improved over time but is still limitedly implemented, despite being highly prevalent and incident, and independently associated with CV death or HF rehospitalizations regardless of EF.

Study context

Population
Patients with HF across the ejection fraction (EF) spectrum, Region Stockholm1,486 with iron biomarkers
Participants
15,197 patients
Exposure
Iron deficiency (ID) vs no ID

Main finding

As reported in the abstract

ID prevalence (patients with iron biomarkers at baseline) · baseline

ID prevalence, overall

55%

ID prevalence, HFrEF

54%

ID prevalence, HF with mildly reduced EF

51%

ID prevalence, HFpEF

61%

Observational data: associations, not effects.

Further findings

OutcomeIRR (95% CI)
HF rehospitalizations; CV death or repeated HF hospitalizations — ID vs No ID · HF rehospitalizations; interaction P 0.21 · regardless of EF1.62 (1.13–2.31)
HF rehospitalizations; CV death or repeated HF hospitalizations — ID vs No ID · CV death or repeated HF hospitalizations; interaction P 0.26 · regardless of EF1.63 (1.15–2.30)

Iron screening

Iron screening improved since 2016 but remained <25% as of 2018

Iron need ≥1500 mg

Patients with iron need ≥1500 mg
72%

All-cause death, cardiovascular (CV) death, first HF hospitalization

ID not associated with all-cause death, CV death or first HF hospitalization

ID incidence (96 without ID at baseline, with follow-up biomarkers) · 6 months

Developed ID within 6 months
21%

Original publication

Iron Deficiency in Heart Failure: Screening, Prevalence, Incidence and Outcome Data from the Swedish Heart Failure Registry and the Stockholm CREAtinine Measurements Collaborative Project. Eur J Heart Fail. Published 10 May 2023. doi:10.1002/ejhf.2879

Summarised from the published abstract; every number is checked against it